Francis Inquiry – one year on

Francis Inquiry – one year on

Author: The Nuffield Trust

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Today marks one year since Sir Robert Francis QC launched the report of his Inquiry into the causes of poor patient care at Mid Staffordshire NHS Foundation Hospital Trust. The Inquiry followed on from a previous independent investigation that was carried out in 2010 by Francis which considered individual cases of patient care.

We have reflected on the year since the Francis Inquiry report was published and Dr Jennifer Dixon, Chief Executive of the Health Foundation, comments:

‘The direct impact of the recommendations of the Francis Inquiry report will not be seen unless NHS leaders support their staff to embed a strong safety culture across their entire organisations. Some NHS providers continue to struggle to improve patient safety training and skills for staff and to adopt a culture in which the patient is top priority.

‘However, all over the NHS there are currently innovative projects with an ambition of improving safety. Through the projects we support, and the research we commission, the Health Foundation has much evidence of how hospitals and teams can deliver a strong safety culture. We would urge NHS staff and board members to take advantage of the lessons from these projects, and many others which exist, to assist staff to improve what they do.’

Examples of NHS related projects that are currently improving patient safety include:

  • A project at Papworth Hospital which we are supporting to improve the care for frail elderly people having heart surgery. Early results indicate that unnecessarily long stays are reduced with 25% of these patients being discharged five days after their operation, compared with over nine days previously.
  • Similarly one of our innovation awards supports a pilot study of emergency surgery in four hospitals to improve patient safety and outcomes. Early results from this initiative indicate an overall 25% reduction in 30 day mortality across the four hospitals although final data analysis is yet to be completed.
  • At Imperial College London, teams are improving patient safety by focusing on junior doctors’ prescribing errors. This work involves pharmacists and doctors working together to design a suitable feedback system to ensure safer prescribing for patients.

To ensure that the recommendations of the Francis Inquiry report are fulfilled, there needs to be cultural change in the NHS. Examples of projects that are helping to develop a stronger patient safety culture include:

  • Our work to support Northumbria Healthcare NHS Foundation Trust to provide safe and compassionate care to frail older people. The Trust is working to understand the barriers to dignified care by prioritising local education initiatives to ensure their workforce, environments and clinical care are fit for purpose.
  • Oxford University Hospitals are developing and evaluating a new approach to staff recruitment using ‘Value Based Interviews’. These ensure new recruits share the same values as the organisation staff and are dedicated to the corporate mission of ‘Delivering Compassionate Excellence’. This project has resulted in some very positive early results including improved indicators of staff satisfaction.
  • The Health Foundation has also recently launched a new £4m improvement programme, Closing the Gap in Patient Safety, with the aim of making demonstrable improvements in safety by tackling known gaps between best practice and current delivery of care.

John Illingworth, a policy manager at the Health Foundation, has also given his reflections in our new blog.


Mike Findlay, Media Manager
T: 020 7257 8047

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